This study examines an example of the alternative conceptions and conceptual errors of students at the higher education level in a scientific context. It begins by introducing the significance and ...characteristics of preconceptions and alternative ideas or alternative conceptions, highlighting their impact on students’ misconceptions. Using the dissolution of a gas (oxygen) in a liquid (water) as the case study, and based on the answers to a questionnaire, this work analyzes the responses by university students which, in most cases, lack scientific rigor. The questionnaire used in this study has been designed in such a way that students provide three types of answers: the first is a yes/no/do not know question; the second is a short answer question to briefly explain the previous answer; and the third is a drawing answer question in which students are required to interpret the phenomenon at the molecular level by drawing a picture. Surprisingly, minimal differences were observed between the university students enrolled in Bachelor’s degree programs (Chemical Engineering or Industrial Engineering) and Master’s degree programs (Master’s Degree in Teacher Training), over the five years (from 2018/19 to 2022/23) covered by this study. Only about 11% of the students provided acceptable reasoning, while the rest demonstrated alternative conceptions. These alternative conceptions encompassed concepts such as the formation of oxygenated water instead of the dissolution, the belief that gases do not dissolve in liquids, confusion about atomic and molecular levels, difficulties in interpreting scientific language, and reliance on simplistic and naïve ideas, among others. After the teacher’s review, the questionnaire and students’ answers were discussed in class in order to detect and correct errors. Approximately one month later, the students were asked to repeat the same questionnaire, when it was observed that the number of correct answers, showing adequate reasoning, had increased to 75%. The results of this study, using a very simple questionnaire that only takes 10 min, could be valuable for guiding teachers to question and transform their pedagogical content knowledge in order to improve the transmission of scientific content, which may involve difficulties that, a priori, were not expected in university students.
In Tehuacán-Cuicatlán valley (Mexico), studies have been carried out on the essential oils of medicinal plants with antimicrobial activity and it was found that they present compounds in common such ...as: α-pinene, β-pinene, carvacrol, eugenol, limonene, myrcene, ocimene, cineole, methyl salicylate, farnesene, and thymol. The goal of this study was to assess the antimicrobial activity of essential oils' compounds. The qualitative evaluation was carried out by the Kirby Baüer agar diffusion technique in Gram-positive bacteria (11 strains), Gram-negative bacteria (18 strains), and yeasts (8 strains). For the determination of the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), the agar dilution method was used. All the evaluated compounds presented antimicrobial activity. The compounds eugenol and carvacrol showed the largest inhibition zones. Regarding yeasts, the compounds ocimene, cineole, and farnesene did not show any activity. The compounds eugenol, carvacrol, and thymol presented the lowest MIC; bactericidal effect was observed at MIC level for
75MR,
128 MR, and
CUSI, for different compounds, eugenol, carvacrol, and thymol. Finally, this study shows that the essential oils of plants used by the population of Tehuacán-Cuicatlán valley share compounds and some of them have antibacterial and fungicidal activity.
There is extensive evidence showing that bilinguals activate the lexical and the syntactic representations of both languages in a nonselective way. However, the extent to which the lexical and the ...syntactic levels of representations interact during second language (L2) sentence processing and how those interactions are modulated by L2 proficiency remain unclear. This paper aimed to directly address these issues by using an online technique (eye-tracking) that is highly sensitive to the lexical and syntactic processes involved in sentence reading. To that purpose, native-speakers of European Portuguese (EP) learning English as L2 at intermediate and advanced levels of proficiency were asked to silently read temporally ambiguous L2 relative clause (RC) sentences disambiguated with a High-Attachment (HA) or Low-Attachment (LA) strategy while their eye-movements were monitored. Since EP and English native speakers differ in the way they process and comprehend this syntactic structure (EP: HA, English: LA), HA preferences were used as a marker of L1 RC syntax interference. Additionally, the cognate status of the complex NP that preceded the RC was manipulated to further analyze how the lexical co-activation of both languages would also affect the syntactic representations of the non-target (L1) language. Results showed cognate facilitation in early and late reading time measures regardless of L2 proficiency, and also that the cognate status of the complex NP impacted L2 reading performance, particularly at lower levels of L2 proficiency. These findings provide compelling evidence for a bilingual reading system that seems to be highly dynamic and interactive not only within each level of processing, but, importantly, across levels of representation. They also suggested that, as the level of L2 proficiency increases, L1 RC syntax interference becomes stronger, in a syntactic parser that seems to operate in a more integrated and nonselective way, with both strategies being equally available to guide L2 reading comprehension. Results are discussed attending to the current models of bilingual syntactic processing.
OBJECTIVES
The aim of this study was to evaluate outcomes in our department after surgery for obstructive hypertrophic cardiomyopathy and to establish the impact of a delay on the indication for ...surgery.
METHODS
From January 1998 to February 2011, 69 patients with obstructive hypertrophic cardiomyopathy and left ventricular outflow tract obstruction at rest were operated on by the same team, and followed up for at least 1 year. We retrospectively analysed clinical data, echocardiography and ambulatory Holter electrocardiogram findings before surgery, early after surgery, at 3 months and annually at follow-up, to detect possible prognostic determinants.
RESULTS
We performed isolated septal myectomy in 59 patients and a combined procedure in 10 patients. Mean outflow tract gradient decreased by 72.2 mmHg (SD 37.3) and there was a mean reduction in thickness of 8.2 mm (SD 5.8) in the interventricular septum. Functional capacity, measured as New York Heart Association class, and angina of effort improved significantly after surgery (P < 0.0001). In-hospital mortality rate was 1.44% for isolated myectomy and 4.35% for combined procedures. Global actuarial survival at 5-year follow-up was 87.4%, but if those patients who were in functional class II or less at the time of surgery were considered, survival rose to 100%. However, 43 patients (62.3%) with functional class III or higher were operated upon.
CONCLUSIONS
Clinical, haemodynamic and mortality outcomes after surgery were excellent, especially in those patients with mild or few symptoms. However, in our location, surgery is still undertaken at an advanced stage of the natural history of the disease, which may adversely affect prognosis.
La vía clínica de recuperación intensificada en cirugía cardiaca (RICC) pretende identificar, difundir y favorecer la implementación de las mejores actuaciones basadas en la evidencia científica para ...disminuir la variabilidad en la práctica clínica. La puesta en marcha de estas prácticas en el proceso clínico global favorecerá la obtención de mejores resultados, acortamiento de estancias hospitalarias y en la Unidad de Cuidados Críticos, lo que permitirá una reducción de costes y una mayor eficiencia. Tras realizar una revisión sistemática en cada uno de los puntos del proceso perioperatorio en cirugía cardiaca, se han redactado recomendaciones basadas en la mejor evidencia científica disponible en la actualidad con el consenso de las sociedades científicas implicadas.
The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.
BackgroundPaediatric Early Warning Systems (PEWSs) improve identification of deterioration, however, their sustainability has not been studied. Sustainability is critical to maximise impact of ...interventions like PEWS, particularly in low-resource settings. This study establishes the reliability and validity of a Spanish-language Clinical Sustainability Assessment Tool (CSAT) to assess clinical capacity to sustain interventions in resource-limited hospitals.MethodsParticipants included PEWS implementation leadership teams of 29 paediatric cancer centres in Latin America involved in a collaborative to implement PEWS. The CSAT, a sustainability assessment tool validated in high-resource settings, was translated into Spanish and distributed to participants as an anonymous electronic survey. Psychometric, confirmatory factor analysis (CFA), and multivariate analyses were preformed to assess reliability, structure and initial validity. Focus groups were conducted after participants reviewed CSAT reports to assess their interpretation and utility.ResultsThe CSAT survey achieved an 80% response rate (n=169) with a mean score of 4.4 (of 5; 3.8–4.8 among centres). The CSAT had good reliability with an average internal consistency of 0.77 (95% CI 0.71 to 0.81); and CFAs supported the seven-domain structure. CSAT results were associated with respondents’ perceptions of the evidence for PEWS, its implementation and use in their centre, and their assessment of the hospital culture and implementation climate. The mean CSAT score was higher among respondents at centres with longer time using PEWS (p<0.001). Focus group participants noted the CSAT report helped assess their centre’s clinical capacity to sustain PEWS and provided constructive feedback for improvement.ConclusionsWe present information supporting the reliability and validity of the CSAT tool, the first Spanish-language instrument to assess clinical capacity to sustain evidence-based interventions in hospitals of variable resource levels. This assessment demonstrates a high capacity to sustain PEWS in these resource-limited centres with improvement over time from PEWS implementation.
Clinical capacity for sustainability, or the clinical resources needed to sustain an evidence-based practice, represent proximal determinants that contribute to intervention sustainment. We examine ...the relationship between clinical capacity for sustainability and sustainment of PEWS, an evidence-based intervention to improve outcomes for pediatric oncology patients in resource-variable hospitals. We conducted a cross-sectional survey among Latin American pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), an improvement collaborative to implement Pediatric Early Warning Systems (PEWS). Hospitals were eligible if they had completed PEWS implementation. Clinicians were eligible to participate if they were involved in PEWS implementation or used PEWS in clinical work. The Spanish-language survey consisted of 56 close and open-ended questions about the respondent, hospital, participants’ assessment of clinical capacity to sustain PEWS using the clinical sustainability assessment tool (CSAT), and perceptions about PEWS and its use as an intervention. Results were analyzed using a multi-level modeling approach to examine the relationship between individual, hospital, intervention, and clinical capacity determinants to PEWS sustainment. A total of 797 responses from 37 centers in 13 countries were included in the analysis. Eighty-seven percent of participants reported PEWS sustainment. After controlling for individual, hospital, and intervention factors, clinical capacity was significantly associated with PEWS sustainment (OR 3.27,
p
< .01). Marginal effects from the final model indicate that an increasing capacity score has a positive influence (11% for every additional CSAT point) of predicting PEWS sustainment. PEWS is a sustainable intervention and clinical capacity to sustain PEWS contributes meaningfully to PEWS sustainment.
This study tries to determine the statistical relation between the most frequent histological types of oesophageal carcinoma in the Metropolitan region of Santiago, Chile. For it there were obtained ...clinical samples of different laboratories of Pathological Anatomy of the Metropolitan region corresponding to the south and east sector of Santiago, gathering a total of 348 cases, which were diagnosed by means of endoscopic biopsy, using as parameters the morphologic characteristics of neoplastic tissue evaluated by light microscopy with hematoxylin-eosin dye. The obtained information was submitted to a model of logistic multiple regression, in order to determine the associations between the most frequent histological types of oesophageal cancer (adenocarcinoma and squamous carcinoma), topographic location compromised to the moment of the diagnosis, age and sex of the patients in study. The proportion between the histological types of cancer of esophagus did not present significant differences, which contrasts with the results of international publications. The analyses demonstrated that the low third is the only parameter that is subject to variation, which relates to the metaplasia of Barrett and the development of oesophageal adenocarcinoma.